Impact Sports: Dr. Bobby Esbrandt
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Guest: Dr. Bobby Esbrandt
Release Date: 9/19/2022
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Steve Washuta: Welcome to Trulyfit. Welcome to the trailer fit podcast where we interview experts in fitness and health to expand our wisdom and wealth. I am your host Steve Washuta, co-founder of Trulyfit and author of Fitness Business 101.
On today’s episode, I interview Bobby s Brandt. You can find Dr. Bobby at impact sports, PT, or Bobby sports PT on Instagram. He is the co-founder and owner of impact sports. He’s a doctor of physical therapy. He’s a strength and conditioning specialist and a sports performance-enhancing coach. We go through his client experience, why he thinks there are more injuries today than ever before, key principles he uses with athletes, and a host of other things concerning training athletes, PT, and overall ideologies behind training.
It was a great conversation with no further ado, here is Dr. Bobby Knight. Bobby, thanks so much for joining the truly fit podcast. Why don’t you give my listeners in the audience a background on who you are and what exactly you do in the health and fitness industry?
Dr. Bobby Esbrandt: Yes, my name is Bobby as Brant. I’m a doctor of physical therapy. I’ve been practicing for seven years now. I’ve built a practice. I’m the owner and co-owner and co-founder of impact sports, physical therapy. We’re based just outside of Baltimore, Maryland. We built a practice that is based on treating the athlete. So we’re very niche based. I also work as the team physical therapist for Coppin State University and Howard State University. I’m at Howard University in Washington, DC. And yeah,
Steve Washuta: cool. I know the area I went to school at West Virginia University. So I had a lot of friends from that area. And then I had buddies who played at Towson and used to be at Towson State now, obviously, awesome. So I’ve been down to that area. And I know that you’re from Baltimore, just because you say Baltimore. So if you d we know that that’s where you’re from.
Dr. Bobby Esbrandt: Yes. That’s a good point. Yeah, I grew up about an hour north of Baltimore City. So more up in hick town up near the Pennsylvania line. But yeah, is that
Steve Washuta: is that Carroll County?
Dr. Bobby Esbrandt: Harford actually,
Steve Washuta: okay. Interesting. Yeah, I don’t know. I don’t know much about that county. But okay, so I had you on because I heard you on other podcasts before I really liked your content. And I think you have a good understanding of training athletes.
And that’s really what this month is about. We’re talking a lot about training athletes. So first, I guess, walk me through your client experience. So if I’m a young athlete, and I come to you, Bobby, what is the first step we take before we start working together?
Dr. Bobby Esbrandt: I mean, it’s it’s been interesting, because we build social media has been such a huge component of how we build our practice. And it’s something I’m not like, it always takes people surprised my sales, but I am not a big social media guy. Like, like I anything personal. I don’t have the personal Instagram. I’ve never on Facebook, I don’t do that stuff.
Dr. Bobby Esbrandt: But you know, I did get a business, Instagram, and it’s the best thing I could have ever done. So a large part of my clientele, they hit me up on Instagram. And they hit me up, they say whatever issue they have, you know, I collect all the information that I need from them, get that to my front desk, and then we get them going and we get them up and through here. Cool.
Steve Washuta: And then is the first step as they come through the door. Are you doing some sort of analysis of all of their physical traits and their skill sets? Is it like a Do you have a list of things that you run down? Are you doing an FMS screen? How exactly do you go about like, initially finding out what it is that it’s best for your athletes?
Dr. Bobby Esbrandt: Yeah, I know, for me, I mean, that’s really the majority of the clients I’m seeing, I do do some training, but 99% of what I’m doing, it’s some athlete who’s coming in with whatever issue it might be, right. But they got knee pain, ankle pain, back pain, whatever it may be. So that’s where my physical therapy training comes into play.
Dr. Bobby Esbrandt: And, you know, we go through a full diagnosis of things, you know, that I think we’ll be looking at, you know, their mobility, their strength, their stability, their movement patterns. You mentioned FMS, which I think is interesting, because I mean, that’s something where like, when I was coming up through school, I graduated PT school in 2014.
Dr. Bobby Esbrandt: And that was kind of like the peak of where FMS was, you know, it was it was, you know, that one study that was done, where they found that it could predict injury risk. And, man, we all know where that kind of turned from there. So no, I mean, I’m not an FMS guy. I’m not asked if I’m a guy, I don’t really I think those things are are good for certain circumstances.
Dr. Bobby Esbrandt: I think if you lack some type of consistent way of how you screen patients, and you want something basic, I think you’d be good. But for me, at this point in my career, I kind of know when they come in within the first couple of minutes of them talking describing their issue, I have a pretty good idea of where that email is going to take me what their deficits are and what I need to look at.
Steve Washuta: Yeah, and assuming you’ve seen all of these things before, right, so you’re just playing off of past clients. And obviously studies but really anecdotal things that you’ve seen I, you know, full disclosure here. My clientele is majority of seniors. So I don’t work with a lot of athletes.
I work with seniors. So so this is intriguing to me when I talk to people to work with athletes, because it’s just something I’ve rarely done. I mean, I’ve worked with a few 17 1819 year olds who are training for, let’s say, like high school football, but I’ve never worked with with a high level athlete before.
Dr. Bobby Esbrandt: Interesting. Yeah, yeah. Yeah. I mean, it’s definitely a different class. My first job out of PT school, it was, you know, in your general, it was, it was a small private practice, but it was a general run of the mill. I kind of wanted to blow my brains out. God bless you for be able to do that. But I mean, I mean, the average age of my patients would be like, 6568.
Dr. Bobby Esbrandt: And, for me, that’s like, you have those ones where it’s incredibly rewarding from the physical therapy standpoint, we were sitting there work with them, but there was so many where they didn’t want to be there. They weren’t a motivated clientele. And I didn’t feel like I was being challenged in any way. I feel like I can give them basic things. And, and from you, where you’re coming from more of the performance Specter, or the personal training Specter, like I can see how that would be. They’re coming here because they want to get better. Yeah,
Steve Washuta: they’re coming there because they want to get better. And then also, you know, I think the difference is, when you’re training younger athletes, at least for me, I get along better with with the adults. So in an hour long personal training session, there’s a lot of conversation. You’re shooting the shit you’re talking about the day you’re talking about their grandkids are things going on.
I just, it’s hard for me to have a conversation with a 16 year old, so but to each their own. That’s why people like you in the industry. Then any people like me, you need you need all types here. But I want to jump to the next question here. Why do you think that we see more injuries today, Bobby than we have ever before? I mean, we’re supposed to be better at injury prevention, and yet people like you and ortho seem to be booked up. Why is this? I
Dr. Bobby Esbrandt: think it’s I think there’s a couple of things. I mean, number one, I think I mean, I’m not I mean, I’m 34 years old, so I’m not that far removed, at least I’d like to think I’m not that far removed from when I was in college when I was in high school. But I think there’s more awareness about a lot of these things to an extent, like I remember back, like when I was playing like, I mean, I didn’t have a strength coach, I didn’t have a gym that I went to go train and mean, every single one of these kids now they have some gym that they’re going to training at, they’ve got their own strength coaches, they have their performance coaches, it’s a different world when it comes to that.
Dr. Bobby Esbrandt: So I think more witnesses one piece, I think COVID played a huge role in things as well, I definitely saw a huge uptick in the amount of Achilles tears, the amount of tendon based issues just because kids were sidelined for so long. You know, I mean, all these tissues, they weren’t stressed the capacity they’re used to, and then they were thrown out there, and they just fell apart. Third thing, and this is something that people have been talking about for a long time, it’s just kids are playing sports for a much longer period of time. Now, there’s not really offseasons anymore. I mean, there’s a lot more specificity nowadays.
Dr. Bobby Esbrandt: And there’s no breaks. So I think when you add that aspect into it, I mean, that’s where we see a lot of these chronic type issues. And kids don’t even know any better. Like I had a girl my last patient I just wrapped up with here today. She’s 14 years old. And you know, she’s been with me for a hamstring strain. But I mean, she’s had knee pain for years. And I had to look at it. I was like, just because you thought it was normal. It’s like you’re 14 is not normal to Oh, it’s not? No, it’s not. So I think there’s a lot of factors that play with it.
Steve Washuta: I think that was a really good point, too. I never thought of that how the sort of the the landscape of fitnesses, excuse me of sports has changed when I was doing this thing. So I’m only two years older than you. You know, we play one sport each season, right? We’re almost forced to you played baseball, football, basketball, whatever, throw soccer in there.
Then maybe you had some sort of offseason where you were lifting, but now it’s like they pick one sport. They’re doing it day and night. And maybe somehow they’re training on Saturday and Sunday for it and they’re seeing a specialist and a personal trainer. Then they’re going to all these different people.
So there that there’s an uptick in that. And I you know, I also think there was a time where you didn’t report injuries as much. So if you if you had what would be now considered a serious concussion. You and me We didn’t report those things. We just played through the concussions. And if you did have some sort of, let’s say, ankle sprain or something maybe you saw the athletic trainer, and then you just took a few days rest and it got bumped down.
You didn’t really go the next level to see an orthopedic unless it was like spine related. You know if it was just exterior pain somewhere wrist, ankle elbow joints, we just said deal with it. I think now adays people are taking it more seriously, which is a good thing. Yeah, no, I completely agree. And I don’t know how you feel about this. But do you feel like people are being overtrained? Is that a reason why not just the fact that there’s training more but that we’re doing too much for these kids? Are they, Are you seeing like what you would consider like overuse injuries?
Dr. Bobby Esbrandt: In some cases? Yes. I mean, I think the other thing that I’m seeing is, you know, I mean, there’s a lot of great people out there doing different types of training, right? Because I mean, kids got they’ve got their skills, coaches, they’ve got their, their strength coaches, they’ve got their peak tees, right, they have their actual coaches, what I’m starting to see more of is like, the skill coach now thinks he’s a strength coach, right.
Dr. Bobby Esbrandt: And he’ll start branching into stuff up in through there, and, and, or vice versa, across the map there. When I see some of the things that kids are doing, like they’re getting a lot of bad information, they’re getting a lot of bad training when it comes to stuff. That’s not every case, but there’s enough of it where it’s not good. I can think of a lot examples off the top of my head of of situations where that’s happened.
Dr. Bobby Esbrandt: But in terms of like, when they’re actually kind of honed in with just like one good trainer, like, like, there’s some really good strength coaches in this area. And I think I think they do a good job. I haven’t had really any bad experiences with any strain periods, or like, well, you’re getting really shitty training there. Don’t feel like that’s it. I think it’s a combination of just no risk just too much between everything. And then there’s certain circumstances where people kind of just aren’t staying in their lane.
Steve Washuta: Yeah, I mean, that makes sense. People. I think sometimes those lanes it’s hard to really draw a line in what what does what to write if you’re like, Oh, I’m gonna like a speed and agility coach, it’s like, Well, does that mean that I’m not allowed to lift weights? Yeah. And if I’m a weightlifting coach, does that mean I’m not allowed to do speed and agility drills with with my athletes?
So I think where you know, where we come in as personal trainers, again, I’ve only worked with like high school athletes. But the athletes I have worked with actually I worked with a guy who was 45 year olds, a triathlete for America who was like, like, representing, like, the triathlete games or something, right? So my focus with him a lot was working on things that he didn’t work on, meaning he was always running and swimming and biking.
I had to look at those muscles he was already working on and then work the other things wherein I think a lot of strength coaches focus on working the same things people are already working, but then they get overworked, if that makes sense. So if you’re a triathlete, you’re really only moving in sort of, like sagittal plane, right? You’re never doing anything rotational unless you consider running rotational. You’re never really working in sort of frontal plane. So I was made sure to do those sorts of things and work on pulling muscles and the things they never do. And I think that’s a problem with strength training
Dr. Bobby Esbrandt: coaches. Yeah. And that’s a good point. Because I mean, that’s something that I I struggle with, especially because me at least my brand new PC, like I have a huge bias towards loading individuals. And you know, it’s a criticism I get often is were like, Oh, that’s not physical therapy. No, that strength and conditioning.
Dr. Bobby Esbrandt: Well, do you know what? Good physical therapy should look like? strengthing auditioning. But it is hard for me like when I have in certain circumstances when at the tag team with the strength coach, because there is so much overlap. And like, you don’t want to double dip into someone you don’t want to overdo it with someone and it is a hard line to kind of walk sometimes.
Steve Washuta: You seem to use a lot of bands related things in your practices. Is that because you learned under someone who did that? Do you just the principles of using them work better? Or just just look better on IG? Why? Why do you use bass?
Dr. Bobby Esbrandt: I do, I didn’t learn anyone with them. I love the variability that they can get like that the amount of uses that I can have you mean you can use them to provide resistance, you can use them to provide accommodating resistance. So for me, like when I’m rehabbing someone and I want to simulate speed, and I don’t want to cover a huge area, like I can get a lot of really great D cell work out of those things.
Dr. Bobby Esbrandt: And that’s what I love so much about them is them to be able to provide that piece because I think that’s an aspect where it’s getting a lot more love nowadays, but I think, three, four or five years ago, like there wasn’t much emphasis on the cell training and the importance of that and the rehab process. So yeah, I mean, I love their use for that stuff.
Steve Washuta: Or there, I guess you would call it injury prevention exercises that you use or that you give to clients or do you just think injury prevention just comes down to assessing someone’s body? And if they’re not mobile enough in certain areas work on mobility, if they’re not strong enough? Your strength? Is it just individual assessments?
Dr. Bobby Esbrandt: Yeah, I mean, that’s, that’s what I do with most of my clients because I mean, they’re, they’re generally coming into me for some type of issue. So like, like a lot of my pro clientele like, you know, like say some of them have like, just chronically they have some type of hamstring issue.
Dr. Bobby Esbrandt: Right. So I mean, I’ll sit down by i Listen, when you when you check into facility, these these are your four things, you run through these things before practice. These are things that are going to help prep you warm you up and through that. So I tried to individualize it with that I know there’s been some decent studies on certain injury prevention programs with, you know, soccer and baseball.
Dr. Bobby Esbrandt: And I think those are good. But there’s just so much variability between individuals where one person’s strength doesn’t mean it’s another’s. And one person’s deficiency doesn’t mean it’s another one. So I think it’s hard to give a blanket one. But I think when you’re dealing with like mass groups, such as like a, you know, a club soccer or something, I think they can be good. I haven’t really gotten involved with that aspect of things. But yeah,
Steve Washuta: so you’ve talked about load before? And you said you were catching some slack? I guess people said, you use a lot of physical therapist, as far as weight is concerned. This is a question I always ask a lot of people again, not not my expertise, when you’re working with athletes, there seems to be and this might be leading question.
At some point, there needs to be a diminishing returns to how much weight you’re using, right? So like, why am I having a wide receiver? Squat? 600 pounds. If that’s not the type of exercise that he’s going to be using, he’s an explosive athlete, he’s never had to come up slow with a lot of weight, like, like, Where does this line of diminishing returns start?
Again, do you train positions differently? or I shouldn’t say trained? Do you work with positions differently? Who people who come in with injuries, but one person has a wide receiver as opposed to alignment? Are you working with them differently?
Dr. Bobby Esbrandt: Yeah, yeah. No, I mean, that that’s a really good question. It’s something that I think you almost have to have a feel for, like I do see and there is value with lifting heavy weights for for a number of different reasons. Number one, strength is paramount, right. I mean, if we look at we talked about injury prevention, when we sit there and we talk about what things are most beneficial in reducing injury risk, strength is far and away the best.
Dr. Bobby Esbrandt: You know, everyone comes in says, oh, you know, I got hurt because I didn’t stretch like now stretching doesn’t do diddly squat. So, from that, I mean, the stronger you can make your tissues funny and just the muscle, so Livesay, like you’re gonna get stronger. It’s gonna make your tissues more resilient. It’s going to make everything from your ligaments, to your tendons to your bones, like, everything becomes stronger.
Dr. Bobby Esbrandt: So the stronger your tissues are, the higher that threshold of failure is right so mean strength is important, but to your point, right from a performance Specter. That’s where like, you know, it is wideout, squatting 500 pounds, ask the grass are really necessary? Well, probably not. I mean, if we sit there, and we look at what the research shows us, like, there’s other things that will help make that athlete more explosive.
Dr. Bobby Esbrandt: So I think the heavy lifting has its place, and you have to know right? What are the benefits? I’m getting out of this? But is more weight equal? More power? More? HighJump? No, not always there is that that line? Like you talked about where, alright, we got as much out of this as what we can. And that’s where we have to use those other training methods to sit there and get what we want from the other aspect.
Steve Washuta: Yeah, yeah, that’s well put. And I think, you know, to add to that, Bobby, there’s only so much time you can work with with an athlete or how much time that they have, right? So if you have a wide receiver coming in, and he’s whatever, post ankle injury and he’s lifting, and he’s asking you questions about what should I do in this,
let’s say 90 minute window, I have each day to work out. If you’re filling it with something, that means you’re taking something else out, right? So it’s not always this good. To me all exercise is good, all strength is good. But what’s better? What’s best? I think that’s the question that people don’t ask.
Dr. Bobby Esbrandt: Now, I think that’s where you sit there and that’s where your your analysis comes in. And your assessment comes in is alright, what is this individuals greatest deficiency, right? So we have this dude’s squatting, you know, if he’s, you know, college male, and he can only squat squat one times his body weight, right? That’s a pretty big issue.
Dr. Bobby Esbrandt: But you know, if that’s dude sitting there, and he can squat, you know, two or two and a half times his body weight, okay, you know, that’s probably not our issue, right? Up and through here. So that’s where that assessment assessment piece comes in. That’s where knowing what you’re looking for, and how you want to progress things comes in, because strength is one piece of the puzzle. It’s not it’s not the single Holy Grail.
Steve Washuta: Are there injuries that you’re seeing more of now than you were surprised by like the Do you have more? I know, you just talked about Achilles, but there are there are injuries that are coming in more now. And now doesn’t have to be post COVID. Just like, before you even became a physical therapist, like while you were in school and going through the process. Are you surprised by a certain type of injury?
Dr. Bobby Esbrandt: Um, I wouldn’t say that anything.
Steve Washuta: What are the ratio? What are the ratios of your injury? Just like a ballpark? Like, are you seeing, like neat like knee surgeries compared to like, ankle sprains like are you what are you seeing the most of
Dr. Bobby Esbrandt: I see it all man if you I see it all lately, and that’s that’s where it’s hard for me like I am in a bit of a unique situation because my entire caseload is athletes. From the day from the morning, when I check in to the time I leave every single app, every single person that walks in here, they’re a high level athlete, so I mean, I see everything.
Dr. Bobby Esbrandt: I wouldn’t say that it leans towards any one thing. I mean, I’d see a lot of ACE yells, I see a lot of hamstring strains. See a lot of shoulder labrum ‘s hip labrum limbs, foot and ankle stuff. Don’t get a whole lot of elbow, the wrist I just would rather not be bothered with it’s not very fun to work with.
Steve Washuta: Can you talk about hamstring strains a little bit? This is something that trainers, again, we’re, as far as our learning understanding, my anecdotal understanding might be different. My wife’s a sports medicine doctor, and I’ve had hamstring issues myself. So I’ve gone down the rabbit hole, but trainers, we don’t learn about those sorts of things.
All we learn is grade one, grade two, grade three, we know it’s grade three, if there’s, let’s say a rupture, and there’s and there’s bleeding. But as far as like, the rehab or when to start or when to finish, we know nothing about that. So how do you deal with hamstring strains?
Dr. Bobby Esbrandt: So hamstring strains, I want to get them in ASAP. I think no matter what soft tissue injury we’re talking about, like the sooner you start, generally, the quicker your return is going to be. So hamstrings are once again, my bias my load towards by my biased towards loading hamstrings, like I’m trying to figure out, alright, what type of load? Can they handle that first day? Right? Like, that’s part of my assessment.
Dr. Bobby Esbrandt: Alright, how bad is this strain? Where are they at? And if you think about like, what the simplest possible loading of that hamstring might be, I literally the first it’s always the first exercise I go to with everyone. I see I had that I had them lay lay in supine, their feet are elevated up on a box, straight leg, can you bridge up on two? Can you take away one and can up centripetal lower down on the one leg.
Dr. Bobby Esbrandt: And I just wanna see what their tolerance is to hamstring load. And with that, that hip and that knee completely locked out. From there, that gives me a piece of information, right, whichever way it goes, I go to the next thing. Next thing I have them again laying on their back, had their knees bent up, they come up into a bridge, and I will see all right, how far can they walk their heels out? I want to see what type of eccentric loading can they tolerate.
Dr. Bobby Esbrandt: Like what range can we get that because when we talk about a hamstring strain, right, obviously, it happens because that tissue and dirt some type of high velocity eccentric force that the hamstring wasn’t prepped, ready to go, right. It’s always typically some type of sprinting mechanism. So our very first goal needs to be restoring your ability to load your hamstring at lengthened states. If you can show me you can start tolerating load at those things.
Dr. Bobby Esbrandt: I can build strength then in those ranges. And then once I have strength, then I start working on trying to build it’s your your tissues tolerance to high speed contractions at those ranges. And I think that last piece is something that is so overlooked when it comes to hamstrings and hamstrings to me, like I love working with him. She says, I think they’re one of the most botched rehabs that I see time and time again.
Dr. Bobby Esbrandt: Because generally, I’ll have kids come in where they’ve had just three, four recurrent strains of the same thing. And Alright, what do you do for it? Well, you know, I stretched it, okay. Held stretching, too. Oh, it hurt. Well, no shit. All right, I still I rested it. And that started running. Okay, what did we do to build this tissue back? And that’s always that missing link?
Steve Washuta: Yeah. I think the problem is why it’s difficult for people who don’t have the education or don’t work with people is that it’s so finicky where you can do one false movement. Maybe your client said, Hey, I thought I was like, 50 60% healed. I did one thing. Now I’m back to square one.
Trainers are afraid of that, right? We’re afraid to like reinjure them. And I think that’s a problem. What, what do you do if you’re doing let’s say, this bridge test? And the second they go up? Even with two legs, they feel something and they’re like, I can’t do this. Do you, Do you just have them rest for a week, Do you haven’t come back? Or do you still give them exercises to do?
Dr. Bobby Esbrandt: No, I’ll do it. Because I can find some type of loading of what I can do and APV that’s not me hitting that hamstring directly, lightly, by trying to hit directly, I can get it through doing some type of glute exercise that’s a little bit more glute dominant, or I can get it through, there’s so many other means where I can do it, but I have to find whatever way I can to load that tissue.
Dr. Bobby Esbrandt: And then I use some of the other means of me as being physical, that stuff that I can do to try to get down some of that pain. Right? So dry needling. And whatever other type of tissue work we might want to do. Those are things I generally try to throw at that first day as well.
Steve Washuta: Yeah, that’s interesting. And that’s good to know. Because I, you know, I think the consensus at least in the personal training industry is like, if there’s a hamstring injury, to stay away from it to tell your client not to not to do anything. And that’s just because I think it really is, it’s not a science thing.
It’s just that everyone’s afraid that they’re gonna re injure their client. And a lot of times to it seems like grade one that you don’t send them up the ladder up the ladder meaning from a personal trainer to a physical therapist, but I think it probably needs to be sent up the ladder because it’s it’s just above our pay grade.
Dr. Bobby Esbrandt: Yeah, no, I think all I think any type of those little strains are something that needs to be seen. Because, like us, I mean, even us, like think back in the day even something as simple as an ankle sprain, right? You played Alright, Well, you know, I sprained my ankle. Alright, it’d be better in a week, no big deal.
Dr. Bobby Esbrandt: I mean, what we find out from a research perspective is that it becomes so much more than ankle sprains so much more than just the ankle sprain, right? I mean, I mean, after an ankle sprain, obviously, the ligaments are stretched out and your ankle becomes a little bit more unstable, right. But I mean, you’ll see a compensation from the joint itself where a lock up, so you’ll have less ankle mobility up on that side, there’s actually a decrease in neural input from the glutes on that affected side. So you have decreased hip strength on that side.
Dr. Bobby Esbrandt: And you can just imagine just from those two things, that cascade of things that you basically open up that that limb to with things that could easily be addressed. And that’s were kind of alluding back to what we talked about before, I think there’s more awareness of things nowadays than there was before because I mean, yeah, like, you certainly would sit there, you see the athletic trainers that tape it up, they were back out there. And sometimes, you still have to do that. But you need to dress it behind closed doors.
Steve Washuta: And I always harp on this with young personal trainers, I mentor. That’s why it’s so important. When you sit down with clients, you’re doing that initial consultation, to not just get a piece of paper where they’re writing out their past injuries, because they forget to write things, or they think things that are important, are important.
They might be like, Oh, I got stitches in my leg, but they don’t tell me about their ankle sprain. I’m like, well, the ankle sprain is more important because now there’s been compensations for the last six years. I don’t care about your stitches. So you have to actually have a conversation with them. Yeah. And sort of needle them to give you every single thing.
I was telling somebody on our past podcast, I was working with someone for a year, and inside of that year, they had mentioned like, briefly in casual conversation that they had a heart attack four years ago. I’m like, You never wrote that on your health history form. So people just don’t tell you.
Dr. Bobby Esbrandt: No, I’m laughing. I’m laughing because of me. It happens time and time again. I mean, just last week, I had a girl who came in for a new bow and she’s high level basketball player, right? She’s she’s going to be playing at Louisville next year. And she’s got knee pain, right? There’s just this knee pain.
Dr. Bobby Esbrandt: Oh, she’ll be here. You know, it just hurts to just have this pain here. I’m like, Okay, so do my little sets, right? Nothing looks like grossly off. And, you know, the next session, she comes in? And she’s like, and we were just like talking. She’s like, Yeah, you know, my, my kneecap has popped out five times on this side. That was what I was like, I could have been told that. It’s just time and time again, you’ll get those types of things. But yeah, I mean, people are funny.
Steve Washuta: Yeah. And I think it’s just like a human nature thing. We have this, we have the amnesia to forget. And think that things happen to us aren’t big deals, like someone was talking about surgery to me the other day. And I was like, I’ve never had surgery. I had surgery twice. I just totally like, forgot that I had surgery because like, neither of them were that big of deals.
But yeah, that’s why you have to probe your clients. And don’t believe it’s not like they’re trying to pull one over on you. They just hear yes, exactly. Stay on topic with a load. It seems like the general public is so into Olympic lifting. Now. Do you see that with your, with your clients? I know, I understand that you’re not necessarily training them.
But are they coming in, and when you talk to them and their strength coaches and working with them is everybody sort of just in the Olympic lifting mode.
Dr. Bobby Esbrandt: And it depends on the strength coach. So like, like, before I started the impact, I had a job up in Baltimore City and worked with a lot of CrossFit CrossFit athletes up there. And so like, obviously, like, I learned the lingo. You know, I know, I know what’s done with them.
Dr. Bobby Esbrandt: But like, from a sport perspective, I have a hard time justifying doing it with the adolescent athlete, or any even a college athlete number one, it’s so damn hard to teach how to do some of those movements. Number two, you think about some of the requisites that are needed to do those movements successfully.
Dr. Bobby Esbrandt: And so to your point, would you talk about earlier right now, like I have this much time with you, how can I maximize my time with this patient? I don’t see it with only lifting. And I’ve seen it with some of the places I’ve in the past where strength coaches have been some of the cause up and with and worked with. strength coaches have been biased towards that.
Dr. Bobby Esbrandt: I mean, we’ve got dudes that, you know, might have 160 degrees of shoulder flexion and they’re snatching. Like it just doesn’t make any sense. And then if you sit then you look at like, I think Olympic lifting is good. And look, I mean, this to me, there’s there’s not a more badass lift on the planet than a good look at snatch. Like, like, that’s impressive.
Dr. Bobby Esbrandt: And I wish I could do one thing, it’d be a good snatch. But, I mean, from a performance standpoint, they’re good, but I don’t know that they provide that much more benefit then. Squatting deadlifting. And the basics. Yeah, there’s been some there’s been some studies that have been done that actually support that.
Steve Washuta: Yeah, I think you make a great point with the with the time thing that we’ve talked about before. And it’s sort of a two part also, the difficulty of a lift. If you don’t have a coach there all the time watching you, you can do more harm than good during a lot of these movements. And then also you see people who try to like perfect these movements.
Now I’m an expert exerciser and sort of expert at my sports. So this is a performance thing and I have to spend 45 minutes on my clean and my snatch, because you will in order to you have to start late and work your way up and work on the form and you need the repetitions to build a neural muscular activity and you have the other neurons going and and all these things.
I think there are there are better ways to spend your time in a strength capacity than doing these movements. I’m not against them again, I think people people are so like, one sided with fitness, they pick one thing out, they love it, they’re obsessed with it all exercises, good. And if that’s what you love to do, go for it. I’m not telling you not to do it. I just think from a performance perspective, I think we’re gonna see a change in the landscape.
I think and this leads to my next question, you have I get it, it’s a different position than being a defensive tackle, let’s say but Tom Brady and your drew breezes, who are more about mobility, and more about using bands and more about nutrition and sleep and bodyweight and less about just hitting the Olympic lifts, do you think things are moving towards there? Do you do a lot of that stuff? I know you use bands, but are you doing? Like, are you using like TRX or using like other forms of like mobility and sort of I would say like rotational training.
Dr. Bobby Esbrandt: I use those things. And that’s where I think like, all of those things have their place. Right? I don’t I think anytime you’re sitting there and you’re programming for somebody, you’ve got to hit things from all angles. Right. I mean, obviously Brady and Brees, they’re, you know, they’re not the most athletic species on the planet. Right.
Dr. Bobby Esbrandt: So I mean, I mean, so I mean, their training is gonna look a little bit different to begin with the same way. Like if you take a pitcher in baseball, right, his training is going to look vastly different than, you know, a catcher. Yeah, or an athletic outfielder, right? I mean, there’s different things that they need.
Dr. Bobby Esbrandt: And that’s where like any type of like throwing athlete, they kind of like, they’re a whole different beast, right? Like, there’s something completely different. But I do still think I mean, there are the people that think they could sit there and just do pure bodyweight stuff, or, you know, little banded glute exercises and think that’s gonna get and that stuff will get you, they have their place.
Dr. Bobby Esbrandt: The if you’re going to be a high level athlete, you need so much more than that stuff. Obviously, the sleep, the nutrition, those are huge pieces. But in terms of training, like I still, you got to be strong, you got to be able to produce scores, you have to be able to absorb force, and you have to move well,
Steve Washuta: yeah, and you know, I like your points, it seems like you can correct me if I’m wrong, you’re, you believe that your strength is the most important thing. And that there are, there are other places for, let’s say, small muscle training and mobility and stretching and those sorts of things.
They but they’re, they’re secondary to strength, or they need to be coupled with strength. And, and this is not my expertise. But in my clients who’ve had let’s say, like, SI joint issues in my, in my older clients who have like a like a pelvic issues, it’s almost always strength that fixes it, stretching makes them feel better, it relieves pain for a short period of time.
In order for us to fix the problem, it’s because things are moving around. It’s not because they’re too tight in certain areas, or if they are too tight, it’s because there’s there’s been compensations and there’s protection of the certain injury because there’s weaknesses everywhere. And we have to wake those muscles up and build them up.
Dr. Bobby Esbrandt: And I think that that tightness piece is big, and I find myself, you know, pretty much given the speech to a patient almost every day because every patient still thinks, you know, um, you know, it’s always the hip flexor too, right? My hip flexors are tight, you know, you have a good stretch quarterback.
Dr. Bobby Esbrandt: And I was like, alright, you know, how long how long you been? It’s been going on for, you know, two, three years. So, okay, okay. Okay, how can you stretch every day? I was like it does it feel different from Monday to Tuesday, no, wakes up is still just as tight, it’s like, so not every tissue that is tight, has to be stretched.
Dr. Bobby Esbrandt: And that’s where, like, everyone’s dumbfounded when I say that stuff. Because like, we’re always taught growing up, you know, stretching, you know, they’ll keep from getting hurt, you just gotta be mobile. But, you know, just because the tissue is tight, doesn’t need to be it needs to be stretched.
Dr. Bobby Esbrandt: Tightness can actually be, and you were alluding to this just a second ago, it can actually be a protective mechanism from your body, right? If your body sits there, and it senses that your tissue is going to work into a range that it feels like it doesn’t have the strength for what’s it gonna do, it’s not gonna let it go there.
Dr. Bobby Esbrandt: Your body is very smart, your body’s not going to put you in a position to fail or get hurt, or at least do its best not to, it’s going to take nothing, I’ll be like, No, you’re not going up in through there. Than the SEC. When you sit there and you load these structures. All of a sudden you sit there and you feel much more mobile, you feel better. So I do think I mean, listen, if you’re weak, I don’t care what it is. If you are weak, that tissue is vulnerable. You are vulnerable.
Steve Washuta: I don’t know a lot about non contact injuries. I know that I see them all the time. I know that typically when we’re watching sports, and we see them, it seems to be ACL is that or more of a genetic component to this? Is this a product of bad exercise regimens? Are people, let’s say, imbalanced in one area? What Why are these non contact injuries happened?
Dr. Bobby Esbrandt: So I mean, I think it’s number one, it’s important to point out that you can do absolutely everything right. And noncontact noncontact injuries, they’ll still be there, they’re still going to happen. With that said, when we look at ACLs, for instance, right, because that’s, that’s the big noncontact one.
Dr. Bobby Esbrandt: No one really Tip No one ever is going to tear an ACL when they’re trying to speed up. Okay, you’re not, you’re not gonna tear your ACL, when you’re sitting there. And you’re, you’re generating some type of force, it’s always with some type of deceleration movement. Okay. So across the board, I think what I’ve seen an athlete can be incredibly fast, he can be incredibly strong, he can be incredibly explosive.
Dr. Bobby Esbrandt:Those things don’t mean that he moves well, it doesn’t mean that he controls his body well. And that’s when we talked about, you know, a little while ago, about making sure we’re hitting every facet, when we’re programming. And those are those pieces that I think it’s so overlooked.
Dr. Bobby Esbrandt: And it’s for a number a couple of reasons, right? I mean, if you look at the collegiate setting, how long does the strength coach have with his guys in the weight room? Right? He only has so long. And so much of emphasis is just put on bigger, faster, stronger. And, you know, to their credit, a lot of it should be put on that. But I think a lot of the other things get overlooked. And even if they’re made aware of them, there’s just not the time to put in to try to address those things.
Steve Washuta: That’s interesting with the deceleration. I never thought of it that way. But you’re right. I mean, that’s where we see those injuries in the deceleration portion, especially with something like a wide receiver who might be running some sort of, I don’t know, come back pattern or a dig. And, you know, he takes a full step when he’s about to make that cut, and then you see him go out. But you know, again, this is anecdotal.
This is just for me watching. I have no data here. It does seem like a lot of times, it’s these wide receivers who look like baby deer, who are super fast, but only running straight and their legs are a little you know, small and skinny. And and and they’re they’re not, you know, they’re not Tyree kill. They’re not quick steppers.
They’re long strikers. And maybe there’s something to that. But is there? I’ve heard in the past that females are more likely to have ACL injuries because of how they’re built. Is that from like, the, the angle of the hips down to the knee? Or is there some other structural reason,
Dr. Bobby Esbrandt: so many females are more at risk to an ACL. There’s still so much about ACL that’s just not known. I mean, that that that angle you’re talking about, it’s called the cue angle, where it’s basically looking at from from the front of your hip bone to the front of your knee to your ankle, and it was wildly are widely assumed and believe that that is a risk factor.
Dr. Bobby Esbrandt: Study after study that’s come out recently, it shows plays no role in it. You know, there’s there’s some thought that, you know, menstrual cycle cycles play a role. Maybe it does, maybe it doesn’t. There’s just so much we don’t know, and a lot of stuff that we feel like we didn’t know, now we’re finding that we don’t know, you know, hop testing and return to sport testing has always been a huge part of returning to sport.
Dr. Bobby Esbrandt: And looking at that stuff. Now, we’re finding out that just because we sit there and you know, they can triple up and show good symmetry, you know, they pass all these hop tests, it shows good symmetry. Athletes are very good compensators. And studies that come out even just this past year, where sits and shows that on that injured leg, injured ACL leg, the end individual actually offset work on to their ankle and on to their hip, to achieve much of that distance.
Dr. Bobby Esbrandt: So they can still have quad deficits, and mask them with these tests. So to be honest, that there’s there’s a lot we still got to know. And that’s where, at least least for me, it’s where I’m trying to add in other things that will help give me a better idea. So I mean, I’ve always been the guy right after an ACL surgery, alright, it’s at least nine months of rehab, right? You’re not coming back to play sport before nine months.
Dr. Bobby Esbrandt: That’s kind of that magic marker. All right, you’ve got to pass all these strength tests aren’t you got to pass your hop tests, you have to be within age and sport norms for those things. Pass your agility tests, and log me you’d look at the RE rupture rate is 20 to 25% for ACLs very high. There’s a lot of things that go into that. I mean, one is not all PT places are kind of built like the way mine is. Right? I mean, you Looking at a standard PT clinic, they might have, you know, a pair of 25 pound dumbbells, you know, a 12 inch box to hop on.
Dr. Bobby Esbrandt: And it sounds bad. But that’s what it is. I mean, when that individual can sit there, and you know, they can squat without pain, they can jog, they can jump, okay, you’re clear, you’re ready. So some don’t even go through that testing process. But even the testing process, it’s been sure that it’s flawed.
Dr. Bobby Esbrandt: There were the things I just said. And so I started getting into ForcePlates. And utilizing those within the last couple of months, and they give us another piece of information that even for myself, it’s been lacking with with with my clients.
Dr. Bobby Esbrandt: And I think that’s the thing that you see, anytime with medicine or with sports performance stuff, like, there’s so much we know, but there’s so much we don’t know, and even stuff that we thought we knew, like it’s changed over the last few years. And we should always be evolving.
Steve Washuta: Can you talk about those ForcePlates? How exactly do you use them? What were they use for originally? Are you using them for the cause that they’re supposed to be used for? Or are you using them differently?
Dr. Bobby Esbrandt: Yes, I mean, the ForcePlates that I have the through valve. And I liked them because they’re, they’re dual ForcePlates. Right. We’ve got two of them. They give me a ton of data on everything under the sun, right? I mean, I can do. If we just talked about like a countermovement jump, right? If I have someone who is CMJ on there, it’ll show me obviously how high they jump, you know what their RSI is? All those performance metrics of how much US centric force they produce and concentric force.
Dr. Bobby Esbrandt: But they’ll also sit there and they’ll show me all right, how much force? Are they putting through one versus the other? What’s that asymmetry? How much force are they landing with with one versus the other. And then I can do everything under the sun with them. I can do single leg CMJ like I can do landing tests. And so it allows me anytime I’m sitting there, and if I can test, a vertical power component versus horizontal hop testing, I’m gonna get a better measure of are what is this quad actually able to do? And I get a quantitative number behind that.
Dr. Bobby Esbrandt: And so if I know that they’re deficient in X, okay, for weeks, I want to train this for weeks later, did my training make the difference that I was trying to make? So it’s, it’s something that I’ve been really excited to use over the last few months, it’s something I’ve continued to be excited to use. And I do think that’s where our field of physical therapy has to move.
Dr. Bobby Esbrandt: There has to be more of a quantitative approach behind what we’re doing. Because the standard, oh, you’ve got four out of five, you know, hip strength, like, that’s so subjective. And that doesn’t tell us anything that we really need to know.
Steve Washuta: Yeah. And you would think that physical therapy more so than even you know, obviously, definitely more. So the personal training needs to be objective and not subjective. And, and have these these numbers, these measurable numbers. Now, sometimes it’s if you don’t have the equipment, you don’t have the equipment.
But that means you need to go to people who have the equipment, because it’s important that you as the person being, you know, worked on, are being let go in and meeting certain criteria and meeting certain criteria and data that isn’t just subjective, that if you went to Bobby as opposed to Jim down the street, Jim says, Okay, you met three of these five, and Bobby says you met five of the five.
How do we really know unless we have these, these numbers and, you know, just going back to speak a little bit about the sort of the injuries we were talking about us as personal trainers, I always tell my personal trainers, you know, we’re not, we’re not physical therapists, we’re not anatomical sleuths.
Even if you’re a corrective exercise specialist with I am, it’s so impossible for me to tell you, if your knee injury came from issues with your hip or issues with your ankle or issues with your knee, right? It’s like, was there some sort of compensation going on that caused the knee injury because of the hip? Or did the you know, foot issue caused the knee injury, which caused a hip issue, if your whole left side is jacked up? I don’t know where it started. But what I’m going to do is strengthen everything.
I’m going to stretch everything, I’m going to work on everything, and then hope that you know, we heal up that way. And then I send you off to a physical therapist, someone like Bobby who can pinpoint better where the injury potentially came from, because that’s not that’s above our pay grade. Yeah. Yeah.
So, you know, speaking to what you do on a on a day to day basis, Bobby, you know, when you’re working with these athletes, I know you you’re again, you’re a physical therapist, by trade, but you have other certifications and degrees and you work in more of a you know, almost a sports performance, you know, realm.
When when you’re working with athletes, who are ready to be released, do they say hey, we want to continue to work with you. We really like what you’re doing. We want to work with you on a one on one basis. Where do you have? Do you send them to someone you trust?
Dr. Bobby Esbrandt: It depends on the athlete. Number one, live life like some I sit there and I will for something like there’s there’s been many over the last few months who who have expressed desire to do so. And you know, I mean, that’s the thing we Being a physical as you develop such a bond, and you know, this is a personal trainer even seems like you have that one on one time with a patient, you’re sit there and you’re seeing them multiple days a week, like, you develop relationships with these people.
Dr. Bobby Esbrandt: And and then, I mean, yeah, you want to help them any way that you want. And when they sit there, and they tell you, hey, you know, we want to continue with you even when we’re done. You just let us know what the price is, you know, we’re we’re going to do it. And yeah, I mean, I’m not going to turn that away. Now, the ones that sit there and they drive, you know, a fair distance to get to me, and then you know, we’re not right around the corner. And yeah, I’m gonna sit there and be like, hey, you know, it’d be really good for you if you get with so and so. So it’s a case by case basis.
Steve Washuta: Yeah. Well, I mean, it’s always good to have clients who you want to continue to work with. But it’s also good to network in the industry and have people downstream. And upstream of you. We talked about this all the time on the podcast.
Again, a lot of listeners are young personal trainers, it’s good as a personal trainer, to know somebody like a Bobby local in your area, and to know a sports medicine doctor and to know whatever a neurologist, and then to know a nutritional counselor or a registered dietician and be able to send your clients to the specialists.
because ultimately, your client is going to appreciate you more than then sending them off to somebody and actually having them do a good job and helping them heal and getting them to the right place than you pretending you know everything in every area right Bobby isn’t, Bobby’s not going to sit down and be like, I’m writing out a diet plan for all of my clients. Why? Because Because Bobby is so good at what he does.
He’s busy during the day doing what he does best. So he doesn’t need to have his hand and everyone else’s pocket so to speak. So I think it’s important I just I say it almost every podcast but to reiterate, you have to network in the industry and you have to stick to what you’re good at.
Dr. Bobby Esbrandt: And I think that’s the I mean when you sit there and when you have those people right if you know a good author if you know a good dietician, if you know a good personal trainer, you know, good strength coach, like it ends up making you look better to the patient’s like, wow, this this student really put me in this guy.
Dr. Bobby Esbrandt: Wow, this is good. And they feel like they’re more well taken care of in that in that respect. Totally. Yeah. It’s definitely important. Yeah,
Steve Washuta: I mean, there’s nothing but positives. There’s no negative to sending somebody away. They’re always going to come back to you. Bobby, this was great information. I really appreciate your time. Let the listeners know where they can find more about you and impact.
Dr. Bobby Esbrandt
So again, my name is Bobby Esbrandt. I’m the co owner of impact sports, physical therapy. We’re located just outside of Baltimore, Maryland. You can find us on Instagram @impactsportsPT or my own @bobbysportspt.
Steve Washuta: My guest today has been Dr. Bobby, thank you for your time. Yes, sir. Thanks for having me.
Steve Washuta: Thanks for joining us on the Trulyfit podcast. Please subscribe, rate, and review on your listening platform. Feel free to email us as we’d love to hear from you.
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